Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1966-12-19
- Stop
- 1966-12-19
The parties
- Patient
- patient Abigail Erica Sauer
- Provider
- provider Remona Sanford
- Payer
- payer No insurance
Record id
026ed208-10c9-c46f-d40d-8abca250b045